Question: How can I make sure my physical therapist is truly qualified in vestibular care?
When someone is suffering from a vestibular disorder, they may experience dizziness, vertigo, imbalance, visual disturbances, and other distressing symptoms. It may be necessary to find a physical therapist (PT) who is trained in vestibular rehabilitation to treat these symptoms and the deficits that occur as a result.
A trained PT specialist will significantly enhance your recovery, compared to a generalized PT. They will be able to get to the root of the problem and utilize interventions that are specific and individualized to achieve optimal outcomes effectively and efficiently.
Check out these tips to ensure your PT is a qualified vestibular specialist.
Training
Inquire about vestibular competency training, certifications, and/or extensive coursework.
Competency courses from institutions like Duke, Johns Hopkins, University of Pittsburgh, 360 Neuro Health, The American Institute of Balance, and the Academy of Neurologic Physical Therapy (ANPT).
These multi-day, hands-on intensives go beyond the basics. If your PT has completed one of these competency courses, they’ve demonstrated in-depth, comprehensive training, have practiced their skills, and have passed the competency tests.
Membership with a Professional Organization
- The clinician is a member of VeDA.
- The clinician is a member of a professional organization such as the Academy of Neurologic Physical Therapy, and more specifically, their Vestibular Special Interest Group.
- The clinician is active in the professional organization(s).
- The clinician self-identifies as a vestibular specialist.
How to search for qualified vestibular specialists
- Use VeDA’s Vestibular Healthcare Provider Directory to find therapists near you. You can enter your address and select the “physical therapist” filter. Click each listing to see their detailed profile, including education and experience.
- Academy of Neurological Physical Therapy directory – A list of NCS-certified PTs.
- The American Institute of Balance directory – A list of professionals who have completed their training.
- Check out company websites specifically. If vestibular therapy is NOT listed as a service, move on.
- Search for “vestibular physical therapist in (insert your city and state).”
Facility & Treatment
Inquire about the treatment they provide in their facility and the facility itself.
- Caseload: Be sure to ask what percentage of their practice is dedicated to vestibular care. A vestibular specialist will have a steady caseload of vestibular patients, compared to a general PT, who may see one or two vestibular patients per month.
- Diagnoses: Ask what types of diagnoses they treat. For example, Benign Paroxysmal Positional Vertigo (BPPV), vestibular neuritis, labyrinthitis, unilateral vestibular hypofunction, vestibular migraine, post-concussion syndrome, PPPD, and Meniere’s disease.
- Equipment: What tools do they have to evaluate and treat vestibular patients?
- Note: It is not essential to have a lot of testing equipment to do a good clinical examination and develop a treatment plan.
- See VeDA’s “How to Choose a Vestibular Specialist” for a list of equipment a vestibular PT might have.
- Evaluation: An initial assessment should be comprehensive and include oculomotor, VOR (vestibular ocular reflex), balance, gait, and coordination testing.
- Treatment: Ask them to describe what a typical treatment session might entail. It should be specific based on exam findings, individualized, and include appropriate progressions.
- Facility: Ask them to describe the physical aspects as well as the ambiance of the facility. You might visit in advance and ask them if you can take a tour.
- Case stories: You might ask the PT to describe stories of some of their successful vestibular patients.
- Ask to speak to the specific therapist who will be treating you. Prepare a list of questions before your visit.
- To receive consistent care, it is best if you receive treatment from the same PT during each of your sessions.
Comfort and personal connection with the provider
During your initial visit:
- Did you feel comfortable with the provider and the environment of the facility?
- Was ample time provided to convey your history and concerns?
- Did they perform a comprehensive examination?
- Did the provider explain your condition and involve you in treatment planning?
- Did you feel respected and heard?
Personal style and patient comfort are vital elements of effective care. Trust your instincts. If you did not feel like the therapist or treatment style was for you, do not hesitate to ask to see a different therapist or go to a different facility.
In summary
To ensure your PT is proficient in vestibular rehabilitation:
- Use VeDA’s directory to search for a qualified vestibular specialist PT near you.
- Confirm they completed a competency-based training program, certificate program, or extensive coursework.
- Verify that vestibular patients make up a steady portion of their clinical practice.
- Verify which diagnoses they treat and have treated.
- Stop by the facility to get a sense of it and meet the therapist before your session.
- Ask as many questions as you need.
- Trust your intuition regarding your comfort level during interactions with the PT and clinical staff, as well as the overall vibe of the facility.
By following this guide, you will be able to find a physical therapist who is qualified to provide vestibular rehabilitation for you.
Author: Denise Schneider, DPT, FAAOMPT, ATC
